Marshall R D, Schneier F R, Fallon B A, Feerick J, Liebowitz M R
Anxiety Disorders Clinic, New York State Psychiatric Institute, New York 10032.
J Clin Psychiatry. 1994 Jun;55 Suppl:33-7.
Social phobia, though the third most common psychiatric disorder in the United States, has received little systematic attention until recently. Chronic and disabling symptoms usually precede other disorders in individuals with comorbidity, including alcohol abuse. Though about 80% of individuals do not seek treatment, controlled trials have demonstrated efficacy for several medications, of which phenelzine (an irreversible monoamine oxidase inhibitor [MAOI]) is the best studied. The benzodiazepines, clonazepam and alprazolam, also hold promise. New reversible MAOIs such as moclobemide and brofaromine are under investigation; fluoxetine and other serotonin selective reuptake inhibitors need further controlled study. The benefits of group cognitive-behavioral therapy also appear substantial. Issues for future investigation include long-term outcome, differential therapeutics, diagnostic subtyping, and combination treatments.
社交恐惧症是美国第三大常见的精神疾病，但直到最近才受到系统关注。慢性和致残性症状通常先于合并其他疾病（包括酒精滥用）的个体出现的其他疾病。虽然约80%的患者不寻求治疗，但对照试验已证明几种药物有效，其中苯乙肼（一种不可逆的单胺氧化酶抑制剂[MAOI]）研究得最为充分。苯二氮卓类药物氯硝西泮和阿普唑仑也有前景。新型可逆性MAOIs如吗氯贝胺和溴法罗明正在研究中；氟西汀和其他5-羟色胺选择性再摄取抑制剂需要进一步的对照研究。团体认知行为疗法的益处似乎也很大。未来研究的问题包括长期结果、差异治疗、诊断亚型和联合治疗。
